Pyorrhoea (Periodontitis) is set of inflammatory disease affecting the periodontium i.e., the tissues that surround and support the teeth. It is probably the second most common disease worldwide, after dental decay.  It is usually a slow process, caused by bacteria that colonise on the teeth and in the sulcus (the space between the teeth and gums). These bacteria create acids,enzymes and toxins that decay and erode the structures that support the teeth (gums and bone surrounding the teeth). Pyorrhoea involves progressive loss of the alveolar bone around the teeth, and if left untreated, can lead to the loosening and subsequent loss of teeth. So Deposits or tartar on the teeth is the single MOST COMMON FACTOR responsible for pyorrhoea or gum diseases.


Pyorrhoea results in a greater degree of bacteraemia (bacteria in blood)especially while brushing and chewing foods. There is sufficient evidence to support the fact that these harmful bacteria and the resultant inflammation can result in a relatively increased risk for:

  • Myocardial infarction (Heart attack) as the bacteria in the blood causes platelets to aggregate resulting in clot formation in blood vessels (atherosclerosis).
  • Cerebrovascular stroke (Brain stroke) due to atherosclerosis
  • Premature delivery/labour pains in pregnant females
  • Low birth weight babies (<2500 grams).
  • In those over 60 years of age, impairments in delayed memory, depression and poor circulation and other brain disorders.
  • Cancer and erectile dysfunction

 A strong association has been established between diabetes and periodontitis. Blood sugar levels are much more difficult to maintain in diabetic patients with pyorrhoea as compared to diabetic patients without pyorrhoea owing to the constant systemic inflammatory state,caused by the periodontal inflammation. Therefore it is a must for all diabetic patients to undergo oral screening to rule out the gum infections (pyorrhoea).


Patients should realize that gum inflammation and bone destruction are largely painless; and in many individuals the disease has progressed significantly before they seek treatment. If you have any of the following symptoms you should visit a Periodontist (Specialists in the treatment of periodontitis and their field is known as "Periodontology" or "Periodontics".)

  • Redness or bleeding of gums while brushing teeth or biting into hard food (e.g. apples)
  •  Gum swelling that occurs frequently even after professional cleaning/scaling.
  • Progressively large gap between the teeth and their outward movement.
  • Halitosis or bad breath, and a persistent metallic taste in the mouth.
  • Gum recession, resulting in apparent lengthening of teeth. (This may also be caused by heavy-handed brushing or with a stiff tooth brush.)
  • Deep pockets (space between gums and teeth) of 6-7 mm or more require specialized cleaning, antibiotics or even surgery with bone grafting  because at this depth there is a high risk of systemic infection and tooth loss, and risk of other diseases.  
  • Loose teeth, in the later stages.


Poor oral hygiene is the single most common causative factor. Other factors include diabetes, smoking, Diet high in sugar and refined carbohydrates and some systemic illnesses.


· Maintain good oral hygiene with proper and effective brushing technique as well as flossing or interdental brushes prescribed by your Periodontist.

· Since pyorrhoea or gum diseases usually results from the deposits/tartar on your teeth especially the deposits beneath the gums, you should undergo cleaning/scaling of your teeth every 6 months or at least once a year by a Periodontist. It makes lots of difference in cleaning by a general dentist and a Periodontist. So choose carefully before you go for cleaning of your teeth.

· If you notice large gaps between your teeth over a duration of time with some loosening, then visit your Periodontist at earliest possible.

· I do not recommend commercial mouthwashes because they contain synthetic chemicals that are absorbed through your mouth and are probably toxic (can cause cancer on long term use), and may prevent the formation of a healthy bacterial biome in your mouth.